Slippery Elm

A while back I saw a patient on an acute basis who was coughing up a lot of fresh blood for about a week. Although it wasn’t the first time in her life that she had experienced this symptom, it had never lasted this long and the amount of blood had never been this heavy. Needless to say, coughing up significant amounts of blood is a pretty serious thing and I wanted her to have a diagnostic work-up done. For a number of years, she had been going through menopause and also had separated from her husband 6 months earlier. So, her symptoms of night sweats and low appetite with a subsequent loss of weight were not unusual in that context. But with fresh blood apparently coming out of her lungs, they took on another meaning – or more accurately, one of two meanings: cancer or tuberculosis.

Alarmed at what seemed the most likely possibilities, I encouraged her to get a diagnostic work-up as soon as possible and wanted to give something to soothe her throat since it had become rather raw from the coughing. Beyond that, I didn’t want to begin any treatment until the diagnosis was clearer.

Not yet having done the comprehensive consultation necessary to decide on a deep acting constitutional homeopathic remedy and not wanting to suppress her symptoms with a local or symptomatic remedy, I decided to use an herbal approach for the throat and wait for the diagnostic results.

To this end, it occurred to me that a commonly used an herb native to North America about which coincidentally, or maybe not so coincidentally, I had just be reading.

The Red Elm tree, a relative of the American Elm otherwise known as Indian Elm, Moose Elm or Gray Elm, had long been highly valued by both Native Americans and the European settlers for a number of purposes, such as the construction of baskets, kettles, canoes and homes, as a food as well as a food preservative, and as a medicine. Nutritional and medicinal preparations use the tree use the inner bark, and are known as ‘Slippery Elm’. The bark is peeled from the tree in long strips and the outer layers then shaved off; the mucilaginous inner bark, which is about 1/8 to 1/4 inch thick, is then dried and put away for use.

In the 1830’s a European traveler to the New World described how he saw witnessed Slipper Elm being used: “The bark, if chewed or softened for a moment in water, … dissolves into a viscous slime, and is found very useful in dressing wounds, as it is cooling, and allays the inflammation. It is said to have been applied, in powder, with success in cholera, and is now apothecaries' shops. A teaspoonful of this bark, in boiling water, makes a very useful beverage, which is sweetened with sugar, and has the same effect as linseed."

The plant was also researched and adopted by American homeopaths in the 19th century, but was considered to be only a minor remedy with limited scope of action for certain cases that exhibited symptoms like numbness, tingling and pain in the arms and legs.

The Native Americans and the herbalists who subsequently learned from them considered it a very powerful healing agent, applicable for numerous conditions and for all sorts of persons including infants, pregnant women and the elderly.

Its viscous nature noted above is due to high mucilage content. Mucilage, produced by most plants to one degree or another, is a gelatinous substance that contains protein and polysaccharides and is similar to plant gums, and has demulcent properties. Herbalists use Demulcents, - the word derives from the Latin demulcere, "caress"- are used by herbalists for their ‘calming’ properties because they form a soothing film over mucous membrane, relieving pain and inflammation of the membrane.

Slippery elm is a demulcent par excellence and it was for this action that it occurred to me to suggest it to the patient in order to soothe the irritation in her throat. Of course, there are many other mucous membranes throughout the body such as the intestinal and urinary tracts, and lungs which all respond favorably to it’s properties.

In addition to being a demulcent, Slippery Elm is also quite nutritious, easily tolerated by those with compromised digestion, and is considered a “survival food” that reportedly was eaten by Revolutionary War soldiers lost in the woods. It is a wonderful food for poorly nourished infants, invalids, aged persons, or any cases where a person may be unable to eat due to lack of appetite, nausea or weakness.

In modern times, Slippery Elm has become an invaluable aid for people undergoing radiation and chemo- therapies. Not only does it soothe the tissues irritated by the treatments, but it also can antidote the common digestive side-effects such as constipation, diarrhea and nausea.

In larger doses, Slippery Elm acts like a bulking agent to promote bowel motions. In smaller quantities, it calms the intestines down, stopping diarrhea. It ought to be noted, though, that since it absorbs large amounts of water, anyone taking Slippery Elm needs to also increase water consumption.

Another common use of Slippery Elm is as an expectorant, that is, as an agent to promote the discharge of mucous from the respiratory tract. It is widely used from phlegmy coughs and any number of inflammations or infections of the bronchi and lungs where phlegm needs to be raised and cleared.

Back to the patient who I had suspected her of having tuberculosis or lung cancer, my hope was that while awaiting a diagnosis the Slippery Elm would merely sooth her throat that had become quite irritated from all the coughing. But the effect far exceeded expectations. Her throat did feel better, but the bleeding stopped, the coughing stopped and her menopausal symptoms like heat flashes and dryness cleared up in short order.

Fortunately, it turned out that the results were negative for both the TB and the cancer and it was surmised that perhaps the bleeding was in fact due to damage to the lining of the throat due to all the coughing. That would make sense of the efficacy of the Slippery Elm in stopping the bleeding, and its well known effect as an expectorant might explain why the coughing stopped altogether. But the action on the hormonal system is still something of a mystery.

Be that as it may, needless to say both of us were quite relieved at the results of both the testing and the Slippery Elm prescription. Since the patient was now without symptoms, she elected not to follow up with the suggestion of the medical doctor to visit a throat specialist, and instead, opted to just continue taking the Slipper Elm for a while longer.

One of the appealing characteristics of this herb is that it can be thought of and consumed as food, not merely a medicine. In the ancient Chinese medical texts, it is written that the purest and highest form of therapy comes from our food and that it is only in the ‘degenerate modern times’ (meaning 3 or 4 thousand years ago) that mankind has become so weak as to need specialized medicines. Although we have come to think of Slippery Elm as an herbal preparation, it could just as well be thought of as a wonderful form of nourishment.

Here are some ways to prepare Slippery Elm, variations of the same basic recipe:

1. Mix one teaspoon of the powder and mix well with same amount of honey or syrup. Add one pint of boiling water, soya milk, nut milk, or cow’s milk. Slowly mix as you add the liquid.

2. Put 2 –3 Tablespoons of the bark powder in 16 ounces of cold water for 6-8 hours, then heat slowly, being careful not to boil. Stir constantly while heating. Strain and drink.

3. Add 1/4 cup of slippery elm bark powder to 2 cups of cold water. Let stand 30 minutes. Slowly heat mixture for 5 minutes, gently stirring to prevent clumping. Let cool, and add sweetener such as honey (highly nutritious) and any spice that appeals to the person. Add peppermint leaves for their cooling action to lungs, ginger root to increase circulation, apple juice in place of water, rosemary leaves for their antioxidant properties. If constipation is a problem, try adding a pinch of clove, fennel or ginger.

3. Slippery Elm Food is generally made by mixing a teaspoonful of the powder into a thin and perfectly smooth paste with cold water and then pouring on a pint of boiling water, steadily stirring meanwhile. It can, if desired, be flavoured with cinnamon, nutmeg or lemon rind.

4. Another mode of preparation is to beat up an egg with a teaspoonful of the powdered bark, pouring boiling milk over it and sweetening it.

5. Slippery elm "gruel": Slowly add fresh, cold water, a little at a time, to the finely powdered bark. Stir until the mixture reaches the consistency of a thick porridge. Sweeten with honey and add cinnamon and ginger to taste. Refrigerate unused portions. Milk may also be used in place of water.

6. In cases where they may be unable to eat due to lack of appetite, nausea or weakness, this may be an option. One to three teaspoons of the powdered inner bark can be added to oatmeal and taken as a food.